Equity in Health Care Across the States: 6 Things to Know

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The Commonwealth Fund’s 2015 Scorecard on State Health System Performance compares states on many aspects of health system performance, including equity. It does so by looking at how two vulnerable populations fare—low-income people and racial and ethnic minorities—on measures assessing their ability to access care, the quality of their care, and their likelihood of living a long and healthy life. Performance rankings are based on equity gaps, defined as the difference between how the state's vulnerable population does and the U.S. average. We learned the following:

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1. Rhode Island has made the most strides in promoting equity in health care since the previous scorecard (2014).



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2. In 37 states, the percentage of low-income elderly adults receiving a high-risk prescription medication declined and the equity gap narrowed.



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3. The majority of states saw an increase in obesity among low-income and minority adults in 2014 compared with 2013.



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4. Premature death rates among racial and ethnic minority populations declined in most states.



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5. For equity gaps based on income, more states improved than worsened.



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6. However, for equity gaps based on race or ethnicity, more states worsened than improved.